A rare case of myocarditis and pulmonary embolism after BNT162b2 mRNA vaccine

In the clinical research arsenal, the COVID-19 vaccines are the strongest weapons against the most important worldwide sanitary crisis of the last centuries. Even if vaccine adverse events have mild clinical relevance, several thromboembolic events occurring after adenoviral recombinant vaccine administration have been reported. Cases of myocarditis and pericarditis after administration of mRNA vaccines have also recently been described. We report the case of a patient who suffered from two rare adverse events after BNT162b2 mRNA vaccine administration (Pfizer-BioNTech): acute myocarditis and pulmonary embolism. Although the temporal consequentiality does not demonstrate a causal link, the strong analogies emerging in the latest clinical reports suggest a possible relation. Further studies are needed to understand the potential mechanisms of myocardial damage and atypical thrombosis. Despite the favorable and self-limiting clinical course of post-vaccinal myocarditis, in these cases a tight follow-up is advisable and vaccine adverse event reporting remains mandatory, especially if not described during pivotal clinical trials

[Role of adherence to chronic drug therapy in patients with cardiovascular disease: an Italian intersocietary consensus document].

Chronic therapy with statins, antihypertensive and antiplatelet drugs is one of the most important interventions for primary and secondary prevention of cardiovascular disease. Adherence to drug treatment is key to successful therapeutic intervention, especially in chronic conditions. This holds particularly true in the setting of cardiovascular diseases, because poor adherence may have serious adverse effects in terms of morbidity and mortality. Many factors may contribute to poor adherence, which can be either patient-related or dependent on the healthcare system, the physician and the environment. The identification and appropriate correction of these factors may result in both clinical and economic benefits. In this setting it is also important to assess the implications of the increasing use of generic or equivalent drugs on adherence to pharmacological therapy

Early Left Ventricular Structural Myocardial Alterations and Their Relationship with Functional and Electrical Properties of the Heart in Myotonic Dystrophy Type 1

Background: Conduction disturbances and arrhythmias characterize the cardiac feature of myotonic dystrophy type 1 (MD1), and a myocardial involvement has been suggested as part of the cardiac disease. The aim of the study was to investigate the role of novel ultrasonic techniques, such as integrated backscatter (IBS) and color Doppler myocardial imaging (CDMI), in the assessment of the subclinical functional and structural myocardial involvement in patients with MD1. Methods: Thirty-one patients with MD1 (MD1 group) without known heart failure were evaluated and compared with 31 healthy, age-matched controls. In all patients, 19 conventional and 28 new echocardiographic parameters (14 tissue Doppler, 10 CDMI, and 4 IBS indexes) were analyzed. Results: In regard to ultrastructural left ventricular (LV) properties, a significantly higher IBS echointensity was found at the septum level in the MD1 group, with a statistically significant correlation with MPI (myocardial performance index) (r = 0.34; P = .05) and PR interval duration (r = 0.40; P = .05). In regard to LV systolic function, the MD1 group showed an early alteration of systolic function compared with controls, evidenced by a significant higher MPI and lower peak strain, strain rate, and cyclic variation index (CVI). In regard to LV diastolic function, the MD1 group showed an early alteration of diastolic function compared with controls, evidenced by lower tissue Doppler imaging, E/A, and E/A strain rate, with a statistically significant inverse correlation to the muscular disability rating scale. On receiver operating characteristic curve analysis, MPI and CVI showed the highest discriminating ability to differentiate the hearts of patients with MD1 from healthy subjects. Conclusion: Highly sensitive ultrasonic techniques can detect early functional and structural alterations of the LV myocardium in patients with MD1. (J Am Soc Echocardiogr 2009; 22: 1173-9.

ACUTE CORONARY SYNDROMES AND DEPRESSION: ROLE OF CIRCULATING ENDOTHELIAL PROGENITOR CELLS

abstract non disponibil

Transcatheter treatment of chronic mitral regurgitation with the MitraClip system: an Italian consensus statement

New percutaneous technologies are rapidly emerging for the treatment of structural heart disease including mitral valve disease. Preliminary data suggest a potential clinical benefit of percutaneous treatment of mitral regurgitation by the MitraClip procedure in selected patients. Until final data are available from randomized, controlled, multicenter clinical trials, there is an urgent need for a consensus among all the operators involved in the treatment of patients with mitral regurgitation, including clinical cardiologists, heart failure specialists, surgeons, interventional cardiologists, and imaging experts. In the absence of evidence-based guidelines, the heart-team approach is the most reliable method of making proper decisions. This study is the result of multidisciplinary consensus activity, and has the aim of helping physicians in the difficult task of making decisions for the treatment of patients with mitral regurgitation. It is the result of a joint effort of the major Italian Cardiology and Cardiac Surgery Societies, working together to find a proper balance between the points of view of the clinical cardiologist, the interventional cardiologist, and the cardiac surgeon

Linee guida per la Sorveglianza Sanitaria in agricoltura

Nel Dicembre 2012 gli Organismi Dirigenti della Societ\ue0 Italiana di Medicina del Lavoro e Igiene Industriale (SIMLII) si sono impegnati in un programma ambizioso ed impegnativo volto ad aggiornare, entro la fine del 2014, la vigente normativa di tutte le linee guida fino ad oggi pubblicate. L\u2019agricoltura rappresenta tradizionalmente un importante settore dell\u2019economia italiana. Queste Linee Guida SIMLII per la Sorveglianza Sanitaria in agricoltura rappresentano un importantissimo strumento di supporto all\u2019attivit\ue0 del Medico Competente impegnato in questo delicato settore